The spine is composed of 24 vertebral bodies as well as the sacrum and coccyx. These vertebral bodies are stacked on top of each other and separated by intervertebral discs. The facet joints are the link between each vertebral body. The biomechanical function of the facet joints is to guide and limit movement of the spine. This protects the spinal nerves from excessive rotation, extension, and other shear forces.
The same way a person may develop arthritis of the hip, knees or hands, they may develop facet joint degeneration. The degeneration can be caused by overuse, dislocation, fracture, injury, instability or osteoarthritis,
There are a variety of ways to diagnose facet joint arthritis including: physical examination, x-ray and MRI. Once the diagnosis of facet joint arthropathy is confirmed, there several treatment options.
Steroids/cortisone can be injected into the facet joint to reduce inflammation and improve pain. Because these joints are so small, however, it is difficult to predict how long these injections might work. As an alternative, radiofrequency ablation of the nerves that supply the joint may be a good option. Prior to the ablation, the patient goes through a series of diagnostic blocks to confirm facet mediated pain.
The ablation is performed with a device that uses a high frequency electrical current to eliminate the transmission of nerve signals. This RFA procedure can provide 9-12 months of relief. If the pain returns, then the patient would be able to repeat the procedure yearly.